Lab Test : Tzanck Smear

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Alternate:Herpes Test
Includes:Microscopic examination of Wright-Giemsa-stained specimen
Department:Pathology, Histopathology Laboratory
Phone:(937) 641-3358
SQ Code:N/A
Available:Mon - Fri, first sift
Turnaround:24 hours
Specimen:Skin scrapings
Container:Glass slide
Temperature:Room temperature, air dried
Rejection:Improper handling, e.g., spray fixing with alcohol.
Uses:To rule out Herpes, multinucleated giant cells.
Limitations:Improperly prepared slides, using a vesicle that is crusted, or not scraping the base of the lesion. Acantholytic cells, which are rounded epidermal cells with large nuclei and scant cytoplasm may be seen on a Tzanck smear. This finding suggests pemphigus vulgaris, an autoimmune blistering disorder. A confirmatory biopsy is necessary when a finding of acantholyic cells is made .

Specimen Preparation:
Label the slides with the patient's name.

Select the lesion site.

Using gloves, cleanse the site with gauze or swab soaked in water.

Incise the top of a vesicle with a sterile scalpel and lightly apply the

specimen to the middle of a glass slide.

Lightly scrape the base of the vesicle and apply the lesion material to the

middle of another glass slide. Smear an area about the size of a dime, i.e.,

just enough to be covered by a No. 1 (22 x 22 mm) cover slip.

Prepare two or more smears if necessary.
Method:Microscopic examination. See "Limitations" below for preparation of sample.

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